One of the major benefits of using EMR is the potential for eliminating all the storage space previously required by paper records, and now that many software programs are offering the option of storing information “in the cloud,” even more space can be freed up by eliminating a lot of the computer hardware previously required.

In simplest terms, cloud computing means storing information on a remote bank of servers and virtually accessing it via the internet, as opposed to housing data on servers maintained by the optometrist in or near the practice.

This can be disconcerting to some ECPs who might worry about whether they still retain ownership of their data when it’s stored somewhere remotely or who may also be concerned about security and the fact that they no longer actually have possession of their information. According to Floyd Webb, vice president of Eyecom3, who said his software company was drawn into cloud computing more than four years ago, these worries are unfounded. “Whether hosted internally on a local network or on the cloud, most software offers a function to export data, and most databases are encrypted,” he said, thus ensuring that the ECP’s data is both available and protected.

Robert A. Hoffman, OD, in private practice in Folsom, Calif., addressed this concern by adding backup storage in his own office. His software vendor, OfficeMate, works with ThinkSmart, Inc. for data storage, and even though the system backs up in three places, Hoffman requested a fourth backup in his office for extra security. “Knock wood, we haven’t had to use it yet,” he said.

In addition to offering cloud computing for OfficeMate, Eyefinity’s Acuity Logic also features this capability. Eyefinity acquired Acuity Logic about two years ago. Currently running in about 300 locations, Acuity Logic is scheduled for a major launch in the near future.

“Cloud computing is becoming much more normal than when we launched it in 2006 when people worried where their information was,” added Scott Jens, OD, FAAO, CEO of software company RevolutionEHR.

However, one important consideration is where your data is actually hosted. It’s important to be sure the servers that compose the cloud your software vendor is using are safe and secure and managed by a reputable company. Webb suggested choosing a software company that utilizes a professional facility such as the one operated by General Dynamics, which not only features built-in redundancies in the case of lost data but which is also bunkered to protect it from disasters and prevent it from losing data in the first place. Another example is Amazon’s cloud, which is where the software company Practice Director stores the information its EMR users generate.

“You still need to know what’s behind the curtain,” agreed Nitin Rai, president/CEO of software company First Insight, developers of MaximEyes software. “You need to know who’s hosting the cloud.” He said that ECPs need to be educated about what the software company they have selected is using as their cloud. “What if something shuts down or if the company goes bankrupt?” he asked.

Another question to ask, is how far away the server site is from your office, according to David H. Hettler, OD, of May & Hettler in Alexandria, Va. He began using MyVisionExpress from Insight Software in his seven-unit practice four years ago “because it was one of the first programs to allow for cloud computing,” he said. The cloud “needs to be somewhat close to you otherwise there’s a lag after your request for information, irrespective of the speed of the server or your connections,” he said. “It needs to be in the same half of the country that you’re in and you need to test it.”

Benefits of Cloud Computing

Modernizing Medicine’s Electronic Medical Assistant is a cloud-based EMR available as a native iPad application or from any web-enabled Mac or PC.

Still, even with all the caveats, the trend continues toward computing in the cloud because the benefits tend to outweigh the negatives. Hettler compared the efficiency of practices going to centralized server farms to the days of the industrial revolution when factories switched from producing their own energy to accessing it from a single power plant. The economies of scale are simply more efficient, and the ECP is freed from managing the maintenance and updates of an in-house server.

“With the cloud, system updates and backups are automatic,” said Brad Rourke, president/CEO, Williams Group/Practice Director, which recently released a cloud-based option.

Adam P. Parker, OD, of Drs. Robinson & Parker in Midlothian, Va., who’s been using OfficeMate for more than seven years, agreed, “Everyone is going to the cloud, because it’s easier for everyone involved. Every time you open up the program you download the latest version. It’s always updated, support is easier and it’s less of a headache to maintain.”

Hettler switched to cloud computing about four years ago after trying for years to integrate multiple locations. He’s described the improvements since then as “logarithmically better,” explaining that the data speed has dramatically increased while the costs have gone way down. To prevent downtime due to internet outages, Hettler maintains two connections at every location, cable with a Verizon 4G LTE backup. “If one goes down, it automatically kicks over,” he said.

By computing in the cloud, you can now access your entire database from anywhere, or at least anywhere that you can connect to the internet via your laptop, tablet, smartphone or other device. “You can use any computer anywhere that has internet access,” said Anthony S. Diecidue, OD, president/CEO of Mountain Computer Systems, makers of Eyebase software. “Cloud systems have come of age.”
■